Trauma: A Social and Medical Challenge

摘要

I must confess that, initially, when I received the invitation to present the Scudder Oration at this event, I was quite surprised. Although, on one hand, I felt extremely honored, on the other, I cannot hesitate to say that I was ap-prenensive about meeting your expectations. I gave extensive thought to what would be the most appropriate manner in which to approach this talk and, having a choice between a highly technical theme versus a more conceptually based one, I opted for the latter. Mine will be a very personal view of a very complex subject and for which I will, at times, avail myself of experiences lived through in Brazil. Inevitably, I will also allude to established concepts and ideas, offering opinions and interpretations slightly different from those that you may be used to hearing. For this reason, I ask that my words be heard with patience and tolerance and that they be interpreted as an effort to contribute to minimizing the impact of this condition that has affected humanity since primordial times, as an integral part of the history of Homo sapiens and of the natural selection process. As a matter of fact, the history of trauma is intertwined with the history of Homo sapiens. Although it has been responsible for deaths, mutilations, sequelae, and suffering, trauma has, nonetheless, played an important role in the slow but inevitable change in the human genome. It is not by chance that, over the millennia, man has acquired the skills necessary to react coherently and effectively to aggression through a series of adaptation mechanisms